Share research - Complementary Food Hygiene

Designing a Food Hygiene Intervention in Low-Income, Peri-Urban Context of Kisumu, Kenya: Application of the Trials of Improved Practices Methodology

shareadmin — Fri, 03 Apr 2020 11:55:31 +0000

This paper by Simiyu et al. (2020) was published in the American Journal of Tropical Medicine and Hygiene. The paper discusses the Safe Start trial. Caregiver practices are important determinants of exposure to foodborne pathogens, and can therefore play a role in reduction in infant food contamination. Through a qualitative approach, the team used the Trials of Improved Practices methodology to design a food hygiene intervention in a low-income settlement of Kisumu city in Kenya. These settlements in Kisumu city host a large portion of the city’s population and are faced with a high diarrheal disease burden. Caregivers were selected if they had a child aged 6–9 months, and together, the researchers codesigned a combination of hardware and messaging components targeting handwashing with soap, hygienic feeding, reheating, and hygienic storage of infant food. Results showed that feeding items were easily adopted by caregivers, whereas reheating of food was less observed. Households reportedly improved their food storage and handwashing practices. As a result, the hardware components were further refined and tested among the caregivers. Messaging components spurred the aspirations that caregivers had for their children and acted as reminders of practicing good food hygiene. The outcomes of the codesign process provided valuable insights on the knowledge of caregivers, a delivery approach for implementing the intervention, and further informed a subsequent trial that adopted the designed intervention to target early childhood exposure to enteric pathogens through contaminated food.

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The Safe Start trial to assess the effect of an infant hygiene intervention on enteric infections and diarrhoea in low-income informal neighbourhoods of Kisumu, Kenya: a study protocol for a cluster randomized controlled trial

shareadmin — Fri, 03 Jan 2020 17:24:12 +0000

This paper by Mumma et al. (2019) was published in BMC Infectious Diseases. The paper describes the Safe Start trial which aimed to assess the effectiveness of a novel infant food hygiene intervention on infant enteric infections and diarrhoea in peri-urban settlements of Kisumu, Kenya. The researchers carried out a cluster randomised control trial with 50 clusters, representing the catchment areas of Community Health Volunteers (CHVs), randomly assigned to intervention or control. A total of 750 infants were recruited on a rolling basis at 22 weeks of age and then followed for 15 weeks. The intervention targeted four key caregiver behaviours related to food hygiene: 1) hand washing with soap before infant food preparation and feeding; 2) bringing all infant food to the boil before feeding, including when reheating or reserving; 3) storing all infant food in sealed containers; and, 4) using only specific utensils for infant feeding which are kept separate and clean. The primary outcome of interest was the prevalence of one or more of 23 pre-specified enteric infections, determined using quantitative real-time polymerase chain reaction for enteric pathogen gene targets. In addition, infant food samples were collected at 33 weeks, and faecal indicator bacteria (Enterococcus) isolated and enumerated to assess the impact of the intervention on infant food contamination.

Download (1.19 MB) Safe Start Marni Brennan Kenya

Hygienic Family community dissemination brief

shareadmin — Fri, 20 Dec 2019 20:37:47 +0000

This leaflet was shared with research participants at a community event to disseminate the findings of the Hygienic Family project. Read our latest blog to find out how the local dissemination activities went.

Download (3.9 MB) Integrating WASH and Food Hygiene in Malawi Marni Brennan Malawi

Policy brief: Improved health and behaviour through integration of food hygiene and WASH

shareadmin — Mon, 02 Dec 2019 20:11:55 +0000

This policy brief details the findings of SHARE's Hygienic Family project conducted in rural Malawi. The brief discusses the findings of the food hygiene and WASH intervention and how policymakers and programme implementers can utilise the project in their work.

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Infant Food Hygiene and Childcare Practices in Context: Findings from an Urban Informal Settlement in Kenya

shareadmin — Mon, 02 Dec 2019 19:25:03 +0000

This study was published by Mumma et al. (2019) in the American Journal of Tropical Medicine and Hygiene. The paper explores the wider contextual issues facing complementary food hygiene interventions in low- and middle-income settings. Such interventions are crucial for reducing infant exposure to diarrhoea-causing enteric pathogens. This study was conducted in an informal settlement in Kenya. Observational and qualitative data on childcare was collected. The findings demonstrate that behaviours associated with food contamination, such as hand feeding and storing food for extended periods, are determined largely by the larger social and economic realities of primary caretakers. Data also show how caregiving within an informal settlement is highly dynamic and involves multiple individuals and locations throughout the day. Findings from this study will help inform the development and implementation of food hygiene interventions in informal urban communities.

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Developing a Contextually Appropriate Integrated Hygiene Intervention to Achieve Sustained Reductions in Diarrheal Diseases

shareadmin — Tue, 17 Sep 2019 09:22:10 +0000

Morse et al. (2019) published this paper in the Sustainability journal. The article discusses formative research carried out to inform the development of an integrated intervention for WASH and food hygiene that aimed to reduce childhood diarrhea in rural Malawi. The researchers explored the personal, social, environmental and psychosocial factors that should be considered in the intervention. A mixed methods approach was used and data was collected from 1079 children between the ages of four to 90 weeks. Four key thematic areas were identified: hand washing with soap; food hygiene; feces management (human and animal); and, water management. The paper also describes the intervention to be delivered and evaluated.

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Toward Complementary Food Hygiene Practices among Child Caregivers in Rural Malawi

shareadmin — Thu, 18 Jul 2019 10:55:13 +0000

Chidziwisano et al. (2019) published this paper exploring complementary food hygiene practices among child caregivers in rural Malawi in the American Journal of Tropical Medicine and Hygiene. Preventable, foodborne diseases remain a global health challenge. Poor food hygiene practices are among the major causes of diarrhoea transmission. This paper details a formative study that was conducted in rural Malawi to inform an intervention design to promote complementary food hygiene practices. An assessment of contextual and psychosocial factors for behaviour change was conducted using Risk, Attitude, Norms, Ability, and Self-regulation model. Three behaviours were examined: washing utensils with soap, keeping utensil in a raised place and handwashing with soap.

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Risk Factors Associated with Feeding Children under 2 Years in Rural Malawi – A Formative Study

shareadmin — Fri, 05 Jul 2019 13:10:59 +0000

Chidziwisano et al. (2019) published this research in the International Journal of Environmental Research and Public Health. The paper discusses the formative research the team carried out in the risk factors associated with feeding young children in rural Malawi. This is a crucial area of research since these risk factors contribute to childhood diarrhoeal disease, a leading cause of morbidity and mortality in under-fives in low income settings. This research was conducted in Chikwawa district, Southern Malawi from June to October 2017. It used a mixed methods approach to collect data from household surveys (n=323), checklists (n=31), structured observations (n=80) and microbiological food samples (n=20). These results offer new insights into poor hygiene practices, risk factors and transmission pathways leading to increased incidence of diarrhoeal disease.

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Enteric pathogen diversity in infant foods in low-income neighborhoods of Kisumu, Kenya

shareadmin — Mon, 03 Jun 2019 10:02:24 +0000

Tsai et al. (2019) published this paper in the International Journal of Environmental Research and Public Health. Pathogen spread through food is a crucial transmission route for diarrhoeal disease in children in low and middle-income countries. This paper explores this under-researched area. The authors examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods and assessed household food hygiene risk factors for contamination in Kisumu, Kenya. Enteric pathogen material was detected in 62% of the infant weaning foods and 37% of foods contained more than one pathogen type. The type of infant food best explained the presence and diversity of enteric pathogens in infant food, with cow's milk carrying a particularly high risk. Most household food hygiene risk factors considered in the study were not significantly associated with pathogen contamination. This research demonstrates the importance of interventions to prevent foodborne transmission of diarrhoeal pathogens to infants in low-income urban settings.

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Promoting hygienic weaning food handling practices through a community based programme: intervention implementation and baseline characteristics for a cluster randomised controlled trial in rural Gambia

shareadmin — Fri, 31 May 2019 13:37:48 +0000

This study, published in BMJ Open by Manjang et al. (2018), describes a clustered randomised control trial of an intervention intended to improve levels of contamination of weaning foods in rural Gambia. Such contamination is a cause of diarrhoea in children under 5 years, but public health interventions to combat this are rare in low-income and middle-income countries. For this work, lessons were taken from previous SHARE funded work carried out by Omprasad Gautam in Nepal; which involved the implementation of a community-based weaning food hygiene programme. The paper describes the design and implementation of an adapted programme; which successfully involved and engaged all levels of community in the study villages.

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